Tuesday, November 27, 2012

During this Thanksgiving weekend we had the joys of having my sisters and their children, along with my flock, for many great feasts. Those joys included feeding and washing dishes for 16 people. After so much washing, it is time to think about getting a new dishwasher. Normally, I would turn to Consumer Reports for advice on the best purchase--but no more. After their most recent article about pork safety, “What’s in that pork?”, I have lost confidence in their ability to provide unbiased, scientific information.

This article violated at least three principles of good scientific reporting. It pushed the data too far, as the number of items (n=198) was not nearly large enough (n> 1,000) to make any strong conclusions. It did not provide enough information to repeat the study, as nothing was said about how the samples were collected, where the sample were collected, who did the lab testing, or what lab methods were used. They also did not compare their results to other published studies. Given the above infractions, we can be confident the results are just about useless.

Although the results are weak and relatively meaningless, the title, headings and tone of the article serve to frighten readers and create anxiety. Contrary to the article’s tone and title, the report does not reveal anything alarming about pork safety. Yersinia enterocolitica is fairly common in pigs and pork , but infection in people is “relatively infrequent,” infects only 1 in 100,000 people, and many cases “resolve on their own without antibiotic treatment.” Low levels of Salmonella and Listeria just remind us that all raw meats need to be handled with care and cooked to appropriate temperatures, a process which kills most bacteria that cause human illness.

Ractopamine is interesting as it is neither a steroid, a hormone, nor a GMO (genetically modified organism). In fact, some of my children take a related compound for occasionally asthma attacks. After extensive testing, it has been approved in 27 countries worldwide. Countries that have not approved it are mostly implementing trade barriers. Thankfully, the Consumer Reports article was objective enough to report that levels they found, 5 part per billion (ppb) were “levels that meet FDA and international food-safety standards.” Think about this if the levels were at the FDA maximum of 50 ppb, the average adult would need to consume over 700 pounds of pork in one day to approach the level of observed effect. I love pork, but not that much!

Lastly, the front page inset mentions that Trichinella levels have gone down due to “changes in industry practices (legislation banned the feeding of certain raw foods to hogs) and public awareness of the risks of eating under cooked meat.” This article fails to mention that these “changes in industry practices” were primarily moves toward modern indoor housing where pigs are away from their manure off the dirt and separate from each other, two practices that are often criticized in pork production. These are also practices I encourage in my children.

Thursday, November 1, 2012

A blog posting by Dr. Richard Raymond, former Undersecretary for Food Safety, and an article published in Food Safety News today both highlighted data indicating that the USDA has significantly decreased inspection of foreign meat producing plants registered to import into the US (1, 2). Over the last 4 years, inspection of meat and poultry producers in countries that supply products to the US has decreased by 60%. USDA/FSIS has dropped from investigating 32 countries in 2005 to just 3 in 2011. So far this year, USDA/FSIS has inspected 11 but would not comment on further investigations for the rest of 2012 (2).

Generally, I have great confidence in our US food supply. However, when it comes to imported meat, I am not so comfortable. Unless we are talking about Northern Europe, it is hard for me to believe that it has nearly the same inspection requirements and quality control protocols as domestically produced meat. Of course, most of the potential hazards of meat can be handled with cooking, regardless of the source of the meat.

What is worrisome is that US consumer groups, animal welfare groups, and environmental groups are making it harder and harder to produce US meat. As that happens, we will be forced to import more. For example, it is estimated that buyers’ refusal to accept Lean Finely Textured Beef (AKA “Pink Slime”) resulted in the need to import 1 MILLION more beef cattle per year in order to meet the gap in supply left when that beef was not entering the human food supply. The food items that had included the Lean Finely Textured Beef still needed to be produced, and the US system simply could not increase production quickly enough to add in this additional lean beef. As a result, the foreign beef, which we have now discovered may not even have been inspected, had to be imported and substituted into the items that needed it. This is a far cry from "local production" or "know your farmer, know your food," unless you speak Portuguese, as they do in Brazil.

In Denmark they have virtually eliminated poultry production due to severe restrictions on antibiotic use. They simply were not able to financially produce the poultry themselves with all of the restrictions, so now they import most of it. Much of their poultry meat now comes from Eastern Europe, a region that was communist only 23 years ago. Danish human campylobacteriosis (a bacterial infection caused by the bacteria Campylobacter) rates have increased 20% from 60 cases per 100,000 people in 2006 to 73.1 cases per 100,000 people in 2011 (3, 4). According to Danish reports on this data, “Consumption and handling of broiler meat is assumed to be the major source of human campylobacteriosis” (2). In addition, 30% of young pigs in Denmark are now exported to be fattened in other countries then imported back into Denmark. Because of all of the new restrictions, the Danes are losing control of their meat supply.

Agriculture remains one bright spot in US trade. Recently, we have had a agricultural trade surpluses in this area (5). However, we may not maintain that surplus if farmers are forced to use production methods from the 1950’s or if they have to treat farm animals like house pets. I am not saying that we do not need to respect the animals – no one respects animals more than farmers. As a civil society, we must consider the consequences of every regulation, law, or consumer demand, not based just on our personal preference, but also on our ability to feed our friends and neighbors. Hungry neighbors are not peaceable. People gotta eat, so if producers cannot work here they will go elsewhere to produce and then import inferior products.

Overall, this change in food inspection protocol abroad raises a potential real food safety and security risk. At the rate we are going, more and more meat is being imported due to the relentless restrictions on the food animal industry in the US. The primary risk here is that we will become too dependent on imported products not be able to feed ourselves. Currently, 17% of our food supply is imported (1), and this number is rising. We are already dependent on foreign oil and consumer goods - are we going let someone else feed us too?

This week’s storm and its potential impact on farms and processors along with the already increasing price of beef and predicted price increases for pork (1, 2) remind us that meat “does not grow on trees,” as my mother used to say about anything I was wasting. The production of food takes effort and resources such as fuel, rain, farmers and processors, to name a few. Stresses to the food system can have a major impact on the price and availability of items we take for granted or easily disparage. Although most of us are currently overfed, that could change.

These stresses to the supply system should remind us that food is something for which we must work. Everyone deserves to eat affordably. Modern production methods help keep food affordable, sustainable and accessible. Many others are not so fortunate. For instance, I was told by a poultry consultant in East Asia that some poultry farms in those countries throw the dead birds over the fence. These birds never go to waste, as people come quickly to collect them for consumption. In one African country, where Iowa State is helping develop a pork industry, the country's king reported that the population starts bush fires to burn the bush meat out the wild, to feed their families.

Food security and having a food supply robust enough for all is not just a concern for the “third world.” This week, as folks work to recover from Sandy, they will go to their local grocer. The shelves may be a little bare, but there will still be food, thanks to the system we have built in this country. Some meat producers even stepped up production in anticipation of hurricane Sandy (3). Also, thanks to the efficiency and larger size of the facilities, they weathered the storm well and had minimal if not no damage. Producers are resuming production as usual and are planning to make deliveries to affected areas in the Northeast as soon as logistically possible (4). Too many disparage the modern system, suggesting we should go back to the “good ole days.” In the “good ole days,” a storm like Sandy would likely leave most people in the East Coast hungry for the period immediately following. Recent events emphasize the need to strive for high quality and efficient production, from farm to fork. So for example, the next time you reject a hamburger because it contain low-fat, high-protein beef (AKA “pink slime”), consider how lucky you are to have the luxury to choose.

Friday, October 19, 2012

The USDA’s Agriculture and Food Research Initiative (AFRI) released their definition of sustainable agriculture, which includes 5 goals and the actions needed to achieve those goals.

The term ‘sustainable agriculture’ (NARETPA, 7 U.S.C. 3103) means an integrated system of plant and animal production practices having a site-specific application that will over the long-term achieve the following goals:

Satisfy human food and fiber needs;

Enhance environmental quality and the natural resource base upon which the agriculture economy depends;

Make the most efficient use of nonrenewable resources and on-farm resources and integrate, where appropriate, natural biological cycles and controls;

Sustain the economic viability of farm operations; and

Enhance the quality of life for farmers and society as a whole.

The National Research Council Committee on Twenty-First Century Systems Agriculture states “that progress toward these goals will require robust systems which adapt to and continue to function in the face of stresses, are productive, use resources efficiently, and balance all four goals…They further state that if the U.S. is to maintain adequate resources to meet food, feed, fiber, and biofuel needs, progress toward meeting the four goals must be accelerated. This acceleration must be based on research that determines ways to reduce tradeoffs and enhance synergies among the four goals while managing risks associated with their pursuit” (USDA/NIFA, 2012).

Antibiotic use in the food animal industry has been shown to increase growth, efficiency, and safety while decreasing economic costs. Compared with these guidelines, antibiotic use in food animals is also productive, uses resources efficiently, and maintains resources to meet food needs. Lastly, antibiotic use in food animals is a perfect example of a research-based method that reduces tradeoffs and manages risks. Although there are some inherent risks in using antibiotics in the food animal industry, the risks and tradeoffs associated with removing them (disease spread, unsafe food supply, carcass contamination, etc) are far outweighed by the benefits of continuing responsible, carefully monitored use.

So, are antibiotics an essential part of “sustainable agriculture”? I believe so.

Monday, October 15, 2012

Early in October, an article was published on CattleNetwork.com by a food-industry journalist who stated that E. coli 0157:H7 is impossible to monitor or identify. Along with Dr. Guy Loneragan (Texas Tech University) and Dr. David Renter (Kansas State University), I wrote a response to the article which explains and cites scientific evidence refuting the journalist’s statements.

Friday, October 12, 2012

The ongoing recall at Canada’s XL Foods, Inc. inspired by E. coli O157:H7 continues to grow. As a result, many media outlets are giving the public the impression that this recall is due to a massive breakdown in the “food safety system.” This interpretation is a bogus hyped-up media frenzy inspired by minority politics and folks looking for a law suit. (1) Gosh, it feels good to be able to say what I feel! After 13 years in USDA, one of those years in a political appointment, it is still difficult to do. During my first week on the job as Deputy Undersecretary for Food Safety (USDA), our agency implemented the largest meat recall in US history (>145 million pounds) due to evidence that Hallmark foods in Chino, CA had harvested downer cows without additional USDA inspection. I have some experience with a sense of “recall hysteria.”(2)

The true facts of a recall must be understood so that people are not afraid to eat! It is terrible when people get sick or die from preventable diseases. Certainly, it is troubling when everyday a new food company announces that they are recalling their product; for example, peanut butter or beef. It is worse when we have one of these “rolling recalls” where the bad news keeps coming. But the news does not always match the true public health impact. As of October 15, fifteen cases of illness and ZERO deaths have been associated with the XL Foods recall.(3) If companies screw up they should fix it, but that does not mean the “whole system” is broken.

These messy “rolling” recalls happen as investigations into the source of the illness uncover new information, particularly information about the “cause” of the recall and how long ago this “cause” started. Note that a recall does NOT mean that product is for sure contaminated. It only means “in an ‘abundance of caution’ there is a chance the product could be contaminated, therefore it is better to pull it off the shelf”. Sorry, I almost sounded like a government guy again.

The peanut butter recall is growing as companies check their records and find that they may have bought product from Sunland, Inc. or someone who sources from them. (4) Again, it does not mean the all peanut butter is contaminated, nor does it mean that Joey’s all natural PBJ sandwich from last week will be the end of him. (Joey is my dog, Joe-Joe, my grandson, and Joseph is my grandfather). On a practical note, it does mean that consumers should check their shelves and return recalled product. It means that we must constantly take ownership of our own food safety. We can keep eating, being thankful for another meal and a system that has the transparency to issue recalls when they needed, and enforce improvements when they are warranted.

Tuesday, October 2, 2012

Farm animals from conventional farms and antibiotic free farms both have strains of antibiotic resistant bacteria. In a recent study conducted at North Carolina State University, researchers found identical sequence types of the resistant bacteria Campylobacter coli (C. coli) isolates in pigs raised on conventional farms as well as antibiotic free (ABF) farms.(1) For those that think banning antibiotic use for food production will solve our resistance problems, this study is troubling.

Dr. Siddhartha Thakur collected thousands of samples from pigs and their surrounding environments over several years and performed tests on 200 strains of C. coli to see if those from ABF farms had similar resistance patterns as those using antibiotics.(3) They did.

This study could be interpreted in many ways: 1) antibiotic use does not make a difference in resistance populations, 2) the evil practice of antibiotic use on-farm is impacting ABF farms, 3) some of the ABF farms may have previously used antibiotics and more time is needed for this resistance to disappear, and/or 4) there is another source of resistance other than antibiotic use.

Dr. Thakur proposes 4) another source of resistance. Dr. Thakur’s two studies over several years indicated that the same antibiotic resistant C. coli bacteria were found on conventional and ABF farms. Because the pig populations had never come into contact with each other, Dr. Thakur concluded that the environment must be contributing to the antibiotic resistant bacteria. (2)

It should be noted that C. coli is unique relative to other types of Campylobacter because it is seen primarily in pigs and it has shown higher levels of resistance. Campylobacter is a leading cause of food borne illness in the United States and has been found in populations of swine, cattle, and poultry. However, cattle and poultry usually shed Campylobacter jejuni (C. jejuni), whereas swine are the main source of Campylobacter coli (C. coli).(1) The scientists at NC State attributed the higher resistance to higher frequencies of recombination in C. coli. Recombination in bacteria is a process in which genetic material is transferred between cells, which allows for fast movement of newly evolved genes.

"In the case of ABF pigs, the environment plays an important role in their exposure to these resistant strains," Thakur says. "If the environment itself, and not the pig, is serving as a reservoir for C. coli, then we will most probably continue to find resistant bacteria populations, regardless of a producer's antimicrobial use." (2)

If Dr. Thakur’s analysis and conclusion are correct, then on farm antibiotic use is unlikely to be increasing any human health risk to C. coli. However, the question of antibiotic resistance must be constantly evaluated on a case-by-case (bug-drug) basis.

A paper was recently released by Dr. Scott Hurd and Dr. Sasidhar Malladi in Foodborne Pathogens and Disease. The paper, entitled 'An Outcomes Model to Evaluate Risks and Benefits of Escherichia coli vaccination in Beef Cattle', discusses the impact of vaccinating cattle for E. coli 0157:H7 on carcass contamination and food-borne illness.

Tuesday, September 18, 2012

An editorial was recently published by Bill Marler’s group entitled “Letter from the Editor: Antibiotic Resistance.”(1) For the most part, I agree with this article. However, there are a few points that I think need clarification. I will use a “point-counter point” approach, although not all of these counterpoints are arguments.

Point: “Antibiotics are integral in the treatment of many food-borne diseases, making this an important issue for the food safety community.”

Counter point: Yes, antimicrobial resistance (AMR) is a big deal. Antimicrobials are used in treating infections. However, they are not the first line of defense for treating food-borne illness, even in cases requiring hospitalization. Instead, the primary course of treatment is fluid therapy.(2) Therefore, even if we could erase AMR in food-borne pathogens, it is unlikely that there will be a significant improvement in the outcome of food-borne illness cases.

Point:

Drug-resistant infections take a staggering toll in the United States and across the globe. Just one organism, methicillin-resistant Staphylococcus aureus (MRSA), kills more Americans every year than emphysema, HIV/AIDS, Parkinson's disease, and homicide combined. Nearly 2 million Americans per year develop hospital-acquired infections (HAIs), resulting in 99,000 deaths - the vast majority of which are due to antibacterial-resistant pathogens. Two common HAIs alone (sepsis and pneumonia) killed nearly 50,000 Americans and cost the U.S. health care system more than $8 billion in 2006.

Counterpoint: The impact of AMR is staggering. Resistant infections have been a problem since the discovery of penicillin, which is the reason for the invention of multiple types of antibiotics.(3) It is also important to realize that very few of the bacteria listed in the above paragraph are related to livestock and food. In addition, several other medically important bacteria, such as Pseudomonas aeruginosa, Streptococcus pneumoniae, and Mycobacterium tuberculosis, have resistance patterns that cannot be explained from livestock antimicrobial usage.(4)

Point: “Antibiotics are becoming less and less effective, in part due to over-prescription and inappropriate use.”

Counter point: I don’t really disagree with this point but I would like to “fine tune” it a bit. As soon as an antibiotic is first used, resistance begins to develop. Bacteria evolve under the selection pressure of antibiotic exposure. It is how they survive. Inappropriate or unnecessary use means extra pressure on the bacterial population, thus increasing the speed of evolution.

To the extent that agriculture is guilty for antimicrobial resistance, we repent. It is important to note that many producer groups are making major efforts to become more prudent in antimicrobial use, just like what is being done in human medicine.

Point: “If I am reading scientists correctly, there are multiple theories for antibiotic resistance and agreement that some occurs naturally in the environment. Some of these theories involve antibiotic uses by both humans and animals.”

Counter point: Both points are correct. The ability to resist antibiotics has been around since the first microbe. Many types of antimicrobial resistance were recently discovered in four million year old dirt that had never been touched by man or beast.(5) Subsequently, any antimicrobial usage, even if appropriate, allows the resistant strains to become more prominent.

Point: “Yet, is it just me, or is antibiotics used in animal agriculture the only thing we hear about when antibiotic resistance comes up? Am I wrong to look at antibiotic resistance as a big circle with animal issues maybe involving a 25 percent slice with lots of other unknowns out there?”

Counter point: No counter argument here. You are correct! Agriculture is taking way too much of the heat for its contribution to antibiotic resistance, and all published risk assessments show this contribution to be negligible. I would venture to say the percentage is much less that 25%. One paper I published shows the average American is more likely to die from a bee sting (1 in 6 million) than to get a few extra days of diarrhea due to macrolide (a common animal antibiotic) use in livestock.(6,7)

Point: “I just have this feeling that allowing animal diseases to go untreated would not contribute to food safety.”

Counter point: Again, I agree. Failure to treat or prevent illness leads to needless animal suffering. Additionally, some new research is showing that healthy animals that have recovered from a respiratory or infectious illness are more likely to be contaminated with foodborne pathogens such a Salmonella or Campylobacter.(8,9)

Point: “Antibiotic resistance is complex issue. Help direct our coverage by suggesting people we should talk to and places we should go. Where's the cutting edge research being done? This is not just some problem on the farm we haven't solved. It's bigger, broader, and more complex. Now, please submit your answers.”

Counter point: Amen brother. There many questions that have not been addressed. If society was not so busy pushing draconian and meaningless solutions such as the PAMTA (Preservation of Antibiotics for Medical Treatment Act) or collecting usage data without good data on resistance, then resources would be available to answer many of your thoughtful questions.

Thursday, September 13, 2012

The Council of Agricultural and Science Technology recently released a video entitled, "The Direct Relationship between Animal Health and Food Safety Outcomes." The video discusses how changing factors that affect animal health (including nutrition, welfare, housing systems, and antibiotic use) can have a significant impact on public health.

Monday, September 10, 2012

Organic is no safer or better than conventional. This is the findings of a systematic review recently published by Stanford University looking at the topic of whether or not food raised organically is superior to food raised by conventional methods.(1) This publication is encouraging to see, as the authors examined hundreds of studies on the topic, not just on a few hand-picked studies. Meta analysis is a powerful objective method for analyzing a collection of conflicting evidence on a scientific topic.

Why is this organic question important? The organic market is seeing a massive increase in sales. According to the paper, the organic sales market went from $3.6 billion in 1997 to $26.7 billion in 2010.(2,3) The debate over organic food continues to heat up. The cost of organic food is usually 2 to three time more. But is it worth the extra cost?

The systematic review looked at two relevant points about how we might define “better”.

The first point is whether or not organic meat has less food-borne pathogens than conventionally raised meat. In analyzing the various studies, the authors did not find any significant difference in the amount of food-borne pathogens present. For example, in chicken 67% of organic samples were contaminated with Campylobacter versus 64% of conventional samples. Salmonella contamination was 35% for organic chicken versus 34% for conventional and E. coli contamination was 65% of organic samples versus 49% of conventional samples.(4)

The second point is whether or not there is antibiotic resistance bacteria present in organic meat, and if the amount of antibiotic resistant bacteria is lower in organic meat. All types of meat, including organic, have the potential to have antibiotic resistant bacteria.(5) While the review reported that conventionally raised chicken and pork are 33% more likely to have antibiotic resistance than organic meat, the findings weren’t statistically significant.1 This means that there is simply not enough data to prove the difference is more than chance. Also, just because meat has antibiotic resistant bacteria, does not mean that harm will necessarily result. A long chain of events must happen for human health harm to occur. First, the antibiotic resistant pathogens need to survive each processing step as well as cooking. Then the consumer needs to ingest the resistant bacteria, and have illness as a result that required antibiotic treatment. The harm would only result if all of these things happened and the bacteria did not respond to the antibiotic therapy.(6)

Bottom line, today’s modern farmer is not going to wipe out the human race. WHEW!

Friday, August 31, 2012

A remarkable paper by Forsberg et al. was just published in Science1.Using sophisticated “high-throughput” (fast and automatic) gene analysis techniques the authors demonstrated that soil contains antibiotic resistant bacteria and that resistance signals (messages, resistomes) are transmitted to other bacteria including types that make humans sick (pathogens).

Now, I am not going to pretend to understand all the technical details of this elegant paper. However, I can understand that some may take this paper’s findings as “alarming”.“The soil is awash with resistance, and it is due to antibiotic use in animals,” they may say.

However, as with all science, one paper’s findings must be compared and viewed in the greater body of knowledge.2Also, when considering causation, timing is key. If we are creating this resistance pool, then there should be a time when little or no resistance existed. However, a few recent and also elegant papers show that antibiotics, as well as antibiotic resistance, have been around for a long, long time, way before people were using antibiotics, and maybe even before people walked the earth.For example, Bhullar et al. found antibiotic multiple resistance in soil in a cave untouched for 4,000,000 years by mammalian life.3 Also, a study from D’Costa et al. found antibiotic resistance in 30,000 year old permafrost.4 Furthermore, another study states that a class of antibiotics called β-lactamases (which includes antibiotics such as penicillin), have been around for over 2 billion years, and even after decades of being used clinically, bacteria are still susceptible.5

I guess that is one more reason Mom made us wash our hands. However, it will be hard to explain to kids as they come screeching inside for dinner, “Wash your hands! That soil contains AB95 resistomes, DUDE!”

Monday, August 27, 2012

A recent report on NPR asks, "Could Antibiotics be a Factor in Childhood Obesity?" Another article on ABC News states, “Antibiotics too soon may set babies up for Obesity: Study.”

I have to say these are about the funniest articles about antibiotics that I have seen in awhile. They are just laden with political implications!

What is funny?

1.Fortunately, the articles are clear that the evidence linking childhood obesity and antibiotic use is not strong.1 NPR states, "Further studies are needed to confirm this trend." Of course, these articles refer to antibiotic treatment of the child, not animals. However, someone has already has made a connection to antibiotic use in food animals.3,4

2.For years some folks have been saying that antibiotic use in livestock does not really improve growth5 . However, these reports suggest even babies grow better with antibiotics6. Additionally, the NPR article did cede that antibiotics in livestock may improve growth.

3.Besides, what is wrong with a “fat” baby? The article admits that the children showed no long term obesity problems, but that will likely be overlooked by the media. Besides, what is what is wrong with a chubby bunny baby? All of my children, except for one, looked like the old “Michelin Man”. Now they are perfect specimens of the human species (North European version).

4.Sadly, like so many others, this article makes obesity someone else’s fault. It is the doctor who gave the antibiotics. Certainly, a baby cannot be expected to control its food consumption, but the parents can. Consumption is the key. It is not the food or antibiotics fault.

Wednesday, June 20, 2012

As a public health veterinarian, I am concerned that a
campaign such as “Meat without Drugs” could result in “Animals without Health”.
A new report from Consumer Reports1 provides some public opinion
data that are not surprising. Given the constant drumbeat about the “overuse”
of antibiotics in livestock production, consumers are frightened and convinced that
there is a problem. One problem is that opinion polls and secret shopper
surveys of labels are not scientific risk assessments. All peer-reviewed
scientific risk assessments have demonstrated a negligible risk of human health
harm due to livestock antibiotic use.2,3,4

I think the bigger problem is that a campaign such as “Meat
without Drugs” could mean that veterinarians have no way to treat sick animals
or prevent epidemic diseases. It is not
possible to raise children without antibiotics. How do people expect us to
raise these baby chicks, piglets and calves into wholesome meat, dairy and egg
products without the assistance of modern medicine? Actually, most of the antibiotics used on the
farm are not the modern cutting edge products used by your local pediatrician.

Do the consumers and Consumer Reports know what happens to
sick animals on organic farms, which produce animals without antibiotics? The
veterinarian does not just give them some chamomile tea and send them to
bed! No, often they go untreated, hoping
to get better. If that does not work then they may be treated (reluctantly) and
then moved into a non-antibiotic-free group, maybe in the same barn. If they do
shed some antibiotic resistant organisms, they are easily shared with their
organic neighbors. But the worst part is
they may go UNTREATED. Once an ill animal is noted by the farmer, it has likely
been sick for a while. There is little time left to treat before it dies. This
waiting or denial of treatment is inhumane!

Data show that only about 13%5 of the total
food-animal antibiotics used are for “growth promotion”. Very soon that amount
will be zero, thanks to new guidance from the FDA6 . The remaining
amounts are to prevent and treat painful deadly animal diseases. Does the
consumer really want us to lose those tools that prevent animal suffering and
improve food safety?

Some people say that raising animals in “crowded” conditions
is the reason for needed antibiotic use. But pigs and kids can still get sick
in any environment. Confinement housing is a means to provide protection from
environmental extremes, predators, wildlife diseases, and stress; therefore
reducing disease. Animal density is carefully monitored to provide optimal health.

Besides animal suffering, the impact of animal health on
food safety and public health cannot be ignored. Healthy animals make safe
food, and conversely marginally healthy
animals increase the risk of contamination from pathogens such as Campylobacter and Salmonella7 Additionally, a new report in Clinical
Infectious Diseases showed an increased risk of Toxoplasmosis from organic
livestock.8 Do you think
Trader Joe’s or Whole Foods really want to sell more of these pathogens?

Monday, May 28, 2012

I
recently read an article in Redbook1 about the risk of antibiotic
use in humans and animals; Not that I normally read Redbook. I never realized
Redbook was such a political magazine. The article was aptly titled “Antibiotics
are not candy.” It makes many good points about how human misuse may be
contributing to the problem with antibiotic resistance in humans. It also raises the valid concern about antibiotic
usage in farm animals which may also be affecting antibiotic efficacy in
humans. However, I need to point out a few potential
untruths in the article.

As terrible as Brody’s MRSA
infection was, it was not from an animal type of MRSA. The type routinely
cultured from pigs and poultry (ST398) rarely affects humans. The CDC has
stated MRSA should not be considered as a foodborne illness.

Other human disease
examples noted in this article are not related to livestock, such as gonorrhea
and carbapenem-resistant Enterobacteriaceae.
(CRE). The association between chicken and urinary tract infections is scientifically
very unproven.

Another common resistant
human infection, Vancomycin-resistant Enterococci (VRE), cannot not be blamed
on vancomycin use in livestock. Europe has
the same rate of VRE as the US and we have never used, in animals, the vacomycin
relative called avoparcin.

The ideas shown in the
compelling figure on page 151 have been evaluated in the multiple scientific
peer reviewed papers and many confidential FDA required risk assessments. All
that work has shown a negligible chance that the events would occur with
frequency to harm the public health.

In regard to the article’s
five (highly political) steps to fight super bugs, I would say:

Use antibiotics
correctly: Amen. The American Veterinary Medical Association and other practitioner groups have long promoted the prudent and judicious use of antibiotics.

Buy meat labeled “raised
without antibiotics” or “organic.”: If animals are raised without antibiotics,
I wonder, “What happened to the ones got sick? Were they denied treatment so
that farmer could get the premium price paid for antibiotic free?”

Ask your favorite
restaurants if they use meat raised without antibiotics: What does a veterinarian do for sick animals
on a farm supplying Chipotle? Does this practice lead to animal welfare abuses?

Spread the message: Amen.
We can all do better. I travel the world telling farmers and veterinarians to “put
their antibiotic use house in order!”

Tell Congress to pass a
law: NO. As the article mentioned FDA
has made a significant change in the way antibiotics will be used; spelling the
end of growth promoting uses. A law is
too broad of a policy tool for this problem. It is like going after a mosquito
with a bazooka.

I agree that resistant
bacteria are an ongoing problem. But they have been for at least 4 million years. Many types of resistant bugs were recently found
in a cave in New Mexico, untouched by civilization.2
(Also, resistant bacteria have been found in antibiotic-free meat, but that’s
another topic for another blog.)3

Wednesday, May 16, 2012

My hat goes off to the Pew organization for utilizing a
special holiday, Mother’s Day, to push its unscientific agenda.1 I must comment on super Moms as I am
married to one! My wife homeschools 8
children, runs two businesses, cares for 3 aged parents and puts up with me.
Also, we raise two or three “natural” pigs a year.

What I can assure you is that Mom will use antibiotics when
any of her babies need it! People forget
that farming is like running a maternity center and/or a nursery. Animals get
sick just like kids. Therefore we need to be prudent in our antibiotic use.
This is my message to veterinarians and mothers.

Preventive use of antibiotics can be prudent. After the
second child in our house is diagnosed with “strep throat” the doctor will
leave an open prescription for whoever in the house may need it, thus saving
another doctor visit; reducing our health care costs. The same is done on the farm. If the
veterinarian can anticipate the disease outbreak, they may prescribe medicine
for the entire group. This prescription
can reduce the total amount of product used on the farm and reduce the number
of dead and suffering animals.

Of course, most Moms are also concerned about the safety of
food for their “flock”. I hope they
understand that healthy animals are an important means to deliver safer meat. In fact a report came out last week
highlighting the inextricable link between animal health and meat safety.2

Some might argue if animals and my multiple kids, for that
matter, were not raised in such high concentration, they would not need
antibiotics. That is just not true. I
bet if you asked only Moms who had never used antibiotics to attend the
“protest” it would have been a thin crowd.

Wednesday, May 9, 2012

On May 7 I presented a commentary in Washington, D.C. for the Council for Agricultural Science and Technology. The commentary, entitled "The Direct Relationship between Animal Health and Food Safety Outcomes," outlines how changes in production practices (for example, antimicrobial use) greatly impacts animal health, which in turn, has a significant impact on public health.

Thursday, April 26, 2012

Given all the hype about a newly discovered case of BSE or “mad cow”, it seems I must comment. I will not give you the main message, that meat is still safe, although it is. Nor will I try to explain the disease and why this atypical case is really “no big deal”, although it isn’t. The USDA and CDC websites do a great job with all those facts. PLEASE READ them.

As an epidemiologist, I must make some comment on the question of testing. A reporter was asking me whether this case suggests we need to test more cattle for BSE. The short answer is “NO”. The testing program was designed by able-brained epidemiologists and statisticians with thorough review by experienced international colleagues. It is designed to do just what it did, find those few cases that occur. The surveillance system is actually quite strong; able to detect BSE in the US “herd” at the very low level of 1 positive in 1 million animals!

Most importantly, we must ask, “what would we do if the USDA tested more animals?” The answer, “the same thing we do now.” Currently, ill animals do not enter the food chain, just like this latest cow did not. Positive animals are reported and carefully investigated. Currently, every cow entering the food chain has BSE infectious material removed so there is no risk to humans.

So what would happen if we doubled the testing from current high level of 40,000 per year to 80,000? We would double the cost and not increase the safety, ….even a smidge.

Thursday, April 19, 2012

This week was one of the rare occasions when I agreed (sort of) with a food safety editorial in the mainstream media. The USA Today piece by (author un-named). (usatoday.com) highlighted the problems when marketing gimmicks (e.g. “pink slime”) and media hype set food safety priorities. I agree some critical and difficult scientific facts and analysis are needed to prioritize and resolve the important food safety issues. Communication fiascos like “pink slime” greatly detract from that effort. A tremendous amount of resources were wasted by those who feed and protect us. I mean, don’t the secretary of Ag and Midwest governors of have better things to do than reassure a public frightened by the media that beef is beef (foxnews.com).

Unfortunately, the science required to address these prioritization questions does not fit into a “sexy slogan” or a sound-bite which must be presented at an 8th grade reading level. The science involves understanding important epidemiological, microbiological and risk assessment concepts such as “attributable risk”, “preventable fraction”, “virulence”, “specificity” and “intervention effectiveness” (to name a few). These are technical concepts that are not easily accepted by the general public or even by many non-quantitative scientists. On the brighter side, I should note that I greatly appreciate the few media personnel and smart congressional staffers that do make the effort to work through the science and understand the issues

Because of the above technical issues, I must say that I disagree with the two alternative, high priority issues, mentioned by the editorialist; antibiotic use and needle injection labeling. Labels have a low “intervention effectiveness. Ask those who have worked for decades to simply get consumers to cook and handle meat properly.

I strongly suggest that we listen to the flock of scientists employed by FSIS, FDA, universities, and the food industry; boring as it may be. We pay them! They have no desire to make anyone sick, nor incite do unnecessary controversy. They don’t get extra funding to scare people. They desire to find answers, fix problems, and make a positive difference.

Wednesday, April 11, 2012

Today (April 11, 2012) the FDA1announced what they termed a “voluntary initiative” limiting the use of antibiotics for “growth promoting” or “production purposes”.Please do not let the genteel approach of my professional FDA colleagues fool you.

This action is big!It will result in the end of all antibiotic uses that are critically important to humans as well as those not labeled for the treatment or prevention of a specific animal pathogen or “bad bug”. 2

Although no published scientific risk assessment has shown a direct human health impact of on-farm antibiotic use, the concern that farmers are creating a “super bug. This, combined with an anti-big agriculture sentiment of many consumer groups3, has led the FDA to determine growth promotion useto be “injudicious” i.e. not in their best judgment. The word injudicious represents an artful move by the politicos (recall, I was one) and shifs the argument from science (risk assessment) to precautionary politics.

Thanks to our democratic society and the patience of most parties involved, this action will produce a much larger and more immediate, yet targeted effect, than legislation or specific regulations could have achieved.Although Guidance 209 does not take effect for 3 years, most of the veterinarians I know in large pork production companies have already begun to comply.Additionally, I can assure you, the packers who buy that pork will make every effort to ensure compliance with FDA’s “voluntary guidance”, particularly through the producer’s Quality Assurance Program.4

References:

1Food and Drug Administration. (11 April 2012). FDA takes steps to protect public health. Available online at <http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm299802.htm?source=govdelivery>2Food and Drug Administration.(2012).Guidance for Industry #209: The Judicious Use of Medically Important Antimicrobial Drugs in Food Producing Animals. Available online at: <http://www.fda.gov/downloads/AnimalVeterinary/GuidanceComplianceEnforcement/GuidanceforIndustry/UCM216936.pdf>3Center for Science In the Public Interest. (11 April 2012). FDA Voluntary Guidance on Antibiotics Tragically Flawed. Available online at <http://www.cspinet.org/new/201204112.html>4 National Pork Board. Pork Checkoff Certification Programs: Pork Quality Assurance.Available online at<http://www.pork.org/certification/default.aspx>

The use of antibiotics in livestock farming has quickly become one of the more popular topics of public debate.The notion that antibiotic use on livestock farms will somehow cause harm to human health is not new. The vigor in which these concerns and fears are being raised has increased. However, sentiment alone cannot be used to make effective public policy decisions. It extremely important for people to understand the true human health risk of these practices, as well as the alternative risks of policy actions that would eliminate antibiotics from agriculture’s tool box and increase animal illness and suffering.

For the record, there has never been a scientifically published risk assessment on-farm antibiotic use, using FDA methods, which demonstrates a meaningful risk to humans.In one risk assessment that I published, on a specific antibiotic widely used in cattle, swine, and poultry, I found there is considerably greater chance of being struck by lightning or dying from a bee sting than any risk of being harmed by livestock antibiotics.The chain of events that would have to occur for antibiotic resistance in humans from livestock is not only extensive, but extremely unlikely.That maybe somewhat surprising to many given most people have been fed a steady diet of information sharing “worries”, “concerns” and “fears” that livestock is the largest perpetrator in human antibiotic resistance.The reality is that concern does not equal risk.You may be worried or concerned that your next commercial flight will have a mechanical problem and crash, however, the true risk of that happening is minuscule.Concern over a health threat means we should study and watch. However the presence of a risk means we should take action to minimize.

The strategic use of antibiotics in animal agriculture is cornerstone of preventing livestock disease. These products are critical to farmers and consumers alike as they aid in providing the safe food supply we currently enjoy.I have published three papers in peer-reviewed scientific journals demonstrating the close connection between animal health and the risk of human foodborne illness. The loss of these products through campaigns led by concern or fear, rather than facts would be detriment us all.The editorial “Wiser practices for farm antibiotics” which ran in the April 4 edition of the Lincoln Journal Star seemed to ignore these important points falling more into the worry and fear camp.The editorial cited Robert Lawrence at the Johns Hopkins School of Medicine as an authority on livestock antibiotics in espousing major concerns about antibiotic use.The editorial failed to note that Lawrence is also a founding director of the “Center for a Liveable Future” at Johns Hopkins, a think tank which is opposed to mainstream agriculture and common practices use by farmers to help feed you and your family, including antibiotics for livestock.

Very soon the Food and Drug Administration is will release new guidance on antibiotic use in livestock which will represent a significant change for farmers, ranchers and livestock feeders.These changes will likely lead to the end of antibiotic use for growth promotion, one of the more popular targets for critics.The guidance is also expected to increase the role of veterinary oversight in on-farm use of antibiotics.Much of this action by FDA is in response to concerns about on-farm antibiotic use. These changes will have a significant impact on farmer, and likely lead to an end of certain antibiotic uses.

Moving forward, I suggest that decisions made about antibiotic use must be founded in science and based on true risks to human health.Anything short of such approach will lead to true human harm by hampering the ability of agriculture to feed a growing population, one that includes you and me.

Monday, April 2, 2012

AUDIE CORNISH, HOST:
It's ALL THINGS CONSIDERED from NPR News. I'm Audie Cornish.
ROBERT SIEGEL, HOST:
And I'm Robert Siegel. Now, the latest in the pink slime saga. That's the derogatory term for a meat product made by processing leftover beef trimmings. The fear over the so-called slime is having economic effects. This week, Beef Products Incorporated or BPI temporarily closed down three meat processing plants in Kansas, Texas and Iowa. Now, the governors of those states are defending the controversial meat product. Yesterday, they toured the only BPI factory still opened in South Sioux City, Nebraska. Iowa Public Radio Sandhya Dirks has the story.
SANDHYA DIRKS, BYLINE: It spread across social media like a virus. Once again, big agriculture was trying to stuff an unsavory, unsafe meat product down the throat of the American consumer. But BPI's co-founder, Regina Roth, says they are not big, bad agriculture.
REGINA ROTH: We are a family-owned business. We try to do the right thing for our company, for our customers, for our employees and for our community.
DIRKS: A lot of consumers don't see it that way. They see the processed meat. It's viscous and thin, like soft serve but beef. Many got their first look on ABC's "World News Tonight." ABC interviewed former United States Department of Agriculture employee Gerald Zirnstein, the man who coined the term pink slime.
(SOUNDBITE OF TV SHOW, "WORLD NEWS TONIGHT")
GERALD ZIRNSTEIN: It's economic fraud. It's not fresh ground beef. It's a substitute. It's a cheap substitute being added in.
DIRKS: But Kansas Governor Sam Brownback blames the name pink slime. He's got another catchphrase in mind.
GOVERNOR SAM BROWNBACK: And I hope the dude, it's beef, catches on...
(SOUNDBITE OF LAUGHTER)
BROWNBACK: ...because that's what this is. Dude, it's beef.
(SOUNDBITE OF LAUGHTER)
BROWNBACK: And it's good beef. My family raises cattle. We've lost 300 jobs in Kansas off of this.
DIRKS: Brownback says just because it's processed doesn't mean it's not meat. Iowa State University professor and former deputy under secretary for food safety at the USDA Scott Hurd says it's like any processed food. BPI takes what gets left behind on the chopping block.
DR. SCOTT HURD: So what they do then is warm those trimmings, and then there's kind of a centrifugal process that's like separating fat from skimmed milk. And so the fatty tissue goes one direction, the lean tissue goes the other direction.
DIRKS: Then they add ammonia, and that has freaked out a lot of consumers. The USDA says that it's actually a pretty foolproof way to kill bacteria, like E. coli and salmonella. But many consumers can't stomach the idea of eating leftover meat that's been treated with a solvent even if they've been doing so for 20 years. Facebook and Twitter campaigns have put pressure on grocery chains and school boards, and it's worked. BPI orders have slowed to a crawl. That frustrates Texas Governor Rick Perry.
GOVERNOR RICK PERRY: I have to go back to Texas and explain to people in Amarillo why they may not have a job. And I'm telling you I don't know the answer to that. Has there been one individual in this country that has been poisoned or has been sick or has died from a product that came out of this company?
DIRKS: The USDA says there hasn't. But even if the public remains squeamish about the product, people are still going to eat hamburgers, and the extra meat once provided by BPI is going to have to come from somewhere, namely 1.5 million additional head of cattle. So to save jobs and redeem BPI's products, the governors are staking their political capital and their stomachs. After the press conference, Iowa's governor, Terry Branstad, takes a bite of a BPI burger.
GOVERNOR TERRY BRANSTAD: It's all right. It's good.
DIRKS: And Governor Branstad says it's nutritious. For NPR News, I'm Sandhya Dirks, South Sioux City, Nebraska.

Saturday, March 24, 2012

On Feb 23, 2012 a great leader in veterinary medicine, my father-in-law, and best friend of 36 years passed away. Dr. C Don Van Houweling was director of FDA’s Bureau of Veterinary Medicine from 1967 to 1978. His office is in charge of all new animal drug approvals including antibiotics. Even in 1975 he was in the midst of the still raging debate about the human health risk of livestock antibiotic use (Grooters 2012). My first encounter with Dr Van Houweling was on the front of the Washington Post, where his public grilling by Senator Ted Kennedy was reported. His daughter and I spent many hours in the Union at Virginia Tech, and occasionally we read the newspaper.

Recently, I had asked Dr. Van Houweling how he had stopped the pressure to ban antibiotics in animal feed generated by the Swann Report (Swann et al. 1969). He answer was immediate and definitive, “we showed the benefit to the animals. (Van Houweling 1977a, 1977b.) Today, if I ask FDA regulators about any analysis that might compare the risk of resistant bacteria to the animal benefit, they reply that they are not allowed to look at the benefit.So in this ongoing effort to ban production and preventive antibiotics and to raise livestock without any antibiotics, I scratch my balding head and wonder, “Who cares about benefit to the animals now?”

References

SwannMM, BaxterKL, FieldHI. 1969. Report of the Joint Committee on the Use of Antiobiotics in Animal Husbandry and Antibiotics. Published by HMSO. Grooters S.V. 2012. Antibiotic Resistance: An Emerging Food Safety Concern. Food Safety Magazine. 18(1):36-45.

Thursday, February 16, 2012

Over 30 years ago as a young dairy veterinarian, I rambled through the Cumberland valley, near Chambersburg, PA, caring for cows in dairies such as the “The Family Cow”. Recently, this Southern Pennsylvania farm was linked to over 75 cases of campylobacteriosis in four states: Pennsylvania, Maryland, West Virginia, and New Jersey.The outbreak ranks as one of Pennsylvania's three most severe raw milk outbreaks in the past five years. This farm and many others in the area symbolize the local family farm ideal. So how can it be responsible for so much suffering?

Campylobacter is not the fault of the dairy farmer or the cow. Studies have shown that,on average 30%of fecal samples (Sato et al. 2004) and 9% of bulk tank samples test positive for Campylobacter (Jayaro and Henning, 2001). The bacterium lives happily in cattle, dogs and many other animals. However, in humans Campylobacter causes diarrhea (often bloody), abdominal pain, nausea, vomiting, and occasionally typhoid-like symptoms, including fever, anorexia, and headache. After infection, long term effects may include Guillian-Barré syndrome (which can cause paralysis) and arthritis (Heyman, 2004).

It boggles my mind that people come from Pittsburg, Philadelphia, and out of state to get their dose of diarrhea from the “Family Cow”. This farm sells 130,000 servings of raw (unpasteurized) milk per month, likely at a premium price. Pasteurization was/is one of the greatest food safety interventions ever implemented, besides cooking. Pasteurization would have prevented these and many other unreported illnesses.

My grandpa had a milk cow and I LOVED raw milk!I likely was exposed to Campylobacter, but became accustomed to those particular strains. Thankfully, I never got tuberculosis, which was once the number one killer of young adults at the turn of the 20th century (Cramer and Frey, 2006). It was stopped by pasteurization, followed by the testing and removal of TB positive cattle. Many many years of research have gone into making the pasteurization process so that it does not alter the nutritional content of the milk, unless of course you want to keep the fecal bacteria.

Food safety officials and inspectors work constantly and frantically to prevent illness from a wide variety of bacteria and food sources. Why does society not let them solve this problem by requiring pasteurization In Pennsylvania, raw milk is labeled with a warning. But, I suppose anyone who is craving a good case of diarrhea will not take time to read the warning label.